Acute Ischemic Stroke with Devastating Consequences Can Occur Due to Posterior Sternoclavicular Joint Dislocation
Dana Ghazaleh1, Apameh Salari2, Leighton Mohl2
1Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA.
Life (Basel, Switzerland)
|November 11, 2022
Summary
Posterior sternoclavicular joint dislocation is a rare orthopedic injury. Prompt diagnosis is crucial as it can lead to severe neurological damage from artery compression, as seen in this case report.
Area of Science:
- Orthopedic Surgery
- Neurology
- Vascular Surgery
Background:
- Posterior sternoclavicular joint dislocation is a rare injury.
- It can lead to compression of vital mediastinal structures, including the subclavian and brachiocephalic arteries.
- Prompt diagnosis and management are critical to prevent severe complications.
Observation:
- A 27-year-old male presented with altered mental status and left hemiparesis after a fall.
- Imaging revealed a posteriorly displaced right medial clavicle and hematoma.
- The clavicle displaced posteriorly, compressing the brachiocephalic artery.
Findings:
- Compression of the brachiocephalic artery led to thrombus formation and distal embolization.
- This resulted in malignant cerebral infarction and significant neurological deficits.
- The patient's hospital course was complicated by cerebral edema, pseudoaneurysm, and remote embolic infarctions.
Implications:
- This case highlights the potential for severe neurological sequelae from posterior sternoclavicular joint dislocations.
- It underscores the importance of early recognition and aggressive management of this rare orthopedic emergency.
- Timely intervention may prevent devastating outcomes such as stroke and permanent disability.
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